[IVH Prevention for ELBW Preterm Babies in Two Different Perinatal Centers]

In a project to carefully observe and minimize risk factors of intraventricular hemorrhages (IVH) in preterm infants, the incidence decreased markedly at the perinatal Center in Ulm, Germany. By comparing its data with the perinatal center in Leipzig, Germany, we sought to identify what improvements could still be made.

A retrospective survey was performed, including 189 infants from Leipzig and 89 from Ulm, all of whom weighed less than 1000 grams. A comparison between both perinatal centers was made.

IVH was more frequently detected in Leipzig (28.4%) than in Ulm (14.6%, p=0.011), yet only the incidence of mild IVH (grade 1-2) was affected since the incidence of severe IVH did not differ between the 2 centers (p=0.59, Leipzig 6.1%, Ulm 4.5%). Furthermore, several potentially avoidable risk factors of IVH were differentially distributed between the 2 centers. For example, postnatal hypocapnia and postnatal hypothermia occurred with higher frequency in Leipzig than in Ulm. Conversely, rapid postnatal application of surfactant was the rule in Leipzig but not in Ulm. Furthermore, sodium bicarbonate application occurred more frequently in Ulm.

Both centers avoided certain risk factors for IVH with varying success. These results allow both centers to specifically target the risk factors that occurred with greater frequency to further reduce the incidence of IVH.